Obesity-associated asthma in children: a distinct entity.

  title={Obesity-associated asthma in children: a distinct entity.},
  author={Deepa Rastogi and Stephen M. Canfield and Andrea Andrade and Carmen R. Isasi and Charles B. Hall and Arye Rubinstein and Raanan Arens},
  volume={141 4},
BACKGROUND Obesity-associated asthma has been proposed to be a distinct entity, differing in immune pathogenesis from atopic asthma. Both obesity-mediated inflammation and increase in adiposity are potential mechanistic factors that are poorly defined among children. We hypothesized that pediatric obesity-associated asthma would be characterized by T helper (Th) 1, rather than the Th2 polarization associated with atopic asthma. Moreover, we speculated that Th1 biomarkers and anthropometric… 

Pediatric obesity‐related asthma: A prototype of pediatric severe non‐T2 asthma

  • D. Rastogi
  • Medicine, Biology
    Pediatric pulmonology
  • 2020
Obesity‐related asthma is utilized as a prototype of non‐T2 asthma in children to discuss several nonallergic mechanisms that underlie childhood asthma and evidence to suggest that dietary interventions, including diet modification, rather than caloric restriction alone, decrease disease burden.

Metabolic Dysregulation, Systemic Inflammation, and Pediatric Obesity-related Asthma.

Together, these recent studies have paved the way to the understanding of obesity-related asthma as a distinct asthma phenotype and have begun to identify the complex relationships between metabolic dysregulation, systemic inflammation, and pulmonary function deficits in obese children with asthma.

Asthma and Obesity in Children

The pathological mechanisms linking obesity and development of asthma in children are summarized and factors influencing this relationship are evaluated, and the possibility to define three main clinical subtypes on the basis of epidemiological data and physiological–molecular pathways is suggested.

Obesity-related asthma in children is characterized by Th1 rather than Th2 immune response: A meta-analysis.


High positivity of skin test in both groups, which is considered a good marker of atopy, shows a preponderant atopic component in the genesis of asthma, both in children with obesity and in those within the normal weight status.

Comparison of Pulmonary Function and Inflammation in Children/Adolescents with New-Onset Asthma with Different Adiposity Statuses

While atopic inflammation plays an important role in the onset of asthma, nonatopic inflammation (including leptin and adiponectin) increases the severity of asthma in overweight/obese patients.

An Overview of the Obese-Asthma Phenotype in Children

Future studies should clarify the exact association between asthma and obesity and the mechanisms underlying the pathogenesis of these two related conditions with the aim to define personalized therapeutic strategies for asthma management in this population.

Association between obesity and asthma – epidemiology , pathophysiology and clinical pro fi

There is a confirmed role of neuro-immune cross-talk mediating obesityinduced asthma, with leptin playing a key role in these processes, and obesity-induced asthma is now considered a distinct asthma phenotype.



Association of Childhood Obesity With Atopic and Nonatopic Asthma: Results From the National Health and Nutrition Examination Survey 1999–2006

Obesity was significantly related to current asthma among children and adolescents and C-reactive protein levels were associated with current asthma in nonatopic children, but not after adjusting for BMI.

Metabolic abnormalities in children with asthma.

This study provides the first set of community-based data linking asthma, body mass, and metabolic variables in children and uniquely describes a statistically significant association between asthma and abnormal lipid and glucose metabolism beyond body mass index associations.

Leptin and asthma in overweight children at 12 years of age

  • X. MaiM. BöttcherI. Leijon
  • Medicine
    Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology
  • 2004
In the VLBW group, the overweight children had a significantly increased risk for current asthma compared with the non‐overweight children after adjustment for the neonatal risk factors [adjusted odds ratio (OR) 5.8, 95% confidence interval (CI): 1.2–27].

Obesity and asthma: lessons from animal models.

  • S. Shore
  • Biology
    Journal of applied physiology
  • 2007
The role of adipokines, especially TNF-alpha, IL-6, leptin, and adiponectin, are focused on, which may lead to novel therapeutic strategies for treatment of the obese asthmatic subject.

Obesity Duration Is Associated to Pulmonary Function Impairment in Obese Subjects

In obese individuals, lung function was significantly lower in subjects with greater years of obesity, and fat loss programs should be encouraged to prevent late pulmonary function impairment.

Increased T-helper interferon-γ-secreting cells in obese children

In obese children, a shift to Th1-cytokine profile dominated by the production of IFN-g is related to insulin resistance as well as to NASH independently of anthropometric features and other metabolic characteristics.

Relation of body mass index to asthma and atopy in children: the National Health and Nutrition Examination Study III

The effects of increased BMI on asthma may be mediated by mechanical properties of the respiratory system associated with obesity or by upregulation of inflammatory mechanisms rather than by allergic eosinophilic inflammation of the airway epithelium.

An official American Thoracic Society Workshop report: obesity and asthma.

There is an urgent need for research to better understand the mechanisms of asthma in the obese, and to develop new therapies specifically targeted to this unique patient population.